Oesophageal mesenchymal tumours: clinicopathological features and absence of Epstein-Barr virus

Abstract

Background-Recent studies have suggested that the Epstein-Barr virus (EBV) is associated with smooth muscle tumours (leiomyoma and leiomyosarcoma) in patients with human immunodeficiency virus and in organ transplant recipients. Leiomyoma is the most common mensenchymal tumour found in the oesophagus. Aim-To report a single institution experience on oesophageal mesenchymal tumours and to determine whether EBV is associated with these tumours. Methods-40 sporadic oesophageal mesenchymal tumours were studied and their diagnosis confirmed on pathological review and immunohistochemical studies. Formalin fixed, paraYn wax embedded tissues from these tumours were analysed for EBV using in situ hybridisation for two messenger RNA (mRNA) probes, EBER and BamH1 W. Results-The oesophageal mesenchymal tumours comprised 36 leiomyomas, two undiVerentiated stromal tumours, and two gastrointestinal autonomic nerve tumours (GANTs). Median age of the patients with leiomyoma (26 men, 10 women) was 62 years (range 30 to 85) and 81% of them had an asymptomatic lesion. The median longitudinal size was 1.2 cm. Multiple leiomyomas were seen in 11% of the patients and calcification was noted in one tumour. Coexisting squamous cell carcinoma was found in one third of cases. The stromal tumours were small, asymptomatic, and located in the lower third of the oesophagus, while the GANTs were large, symptomatic, and found in the upper third of the oesophagus. EBV mRNAs were not detected in all these tumours. Conclusions-The clinicopathological features of oesophageal leiomyoma, undiVerentiated stromal tumour, and GANT were diVerent. Some oesophageal leiomyomas were associated with oesophageal squamous cell carcinomas. EBV is not associated with sporadic oesophageal mesenchymal tumours. (J Clin Pathol 1999;52:758-760)

Updates on World Health Organization classification and staging of esophageal tumors: implications for future clinical practice

“…[69] In a large series (n=36), the mean age of patients with leiomyoma at presentation was 62 years and multiple leiomyomas was seen in 11% of the patients. [70] Granular cell tumour of oesophagus has a prediction for lower oesophagus and more often occur in females. [71] The tumour mainly occurs in patients in the fifth decade of life.…”